Impact of Prescribing and Adherence-Related Drug Problems on Acute Coronary Syndrome Outcomes: A Prospective Study in Vietnam

Dinh Nguyen; Thang Nguyen

doi:10.22146/ijp.25259

Dinh Nguyen Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
Thang Nguyen Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

Keywords: Acute coronary syndrome, Drug-related problems, Prescribing practices, Medication adherence, Clinical outcomes

Abstract

Background: Drug-related problems (DRPs) substantially affect clinical outcomes in acute coronary syndrome (ACS). These problems commonly arise from inappropriate prescribing and poor patient adherence after discharge. In Vietnam, comprehensive evaluations of these DRPs are still limited. Objective: To determine the prevalence, characteristics, and clinical impact of prescribing and adherence-related DRPs among ACS patients, and to evaluate their association with adverse treatment outcomes post-discharge. Methods: A prospective observational study of 78 ACS patients at a cardiovascular hospital in Can Tho, Vietnam (Aug 2023–Jan 2024). DRPs were identified at discharge and monthly for 3 months via prescription review and patient interviews, and classified per Vietnam Ministry of Health guidelines (drug selection, dosing, inadequate treatment, non-adherence). Associations between DRPs and adverse outcomes (readmission or mortality) were examined using multivariate logistic regression. Results: Among 78 ACS patients (66.7% male, mean age 66.6 ± 11.8 years), rug-drug interactions were the most common prescribing-related DRP, identified in 42.3% of patients at discharge, with a decreasing trend over follow-up. Dosing-related DRPs were prevalent at discharge (61.5%) and reduced to 26.6% by month three. Inadequate treatment at discharge was noted in 11.5% of patients. Non-adherence-related DRPs peaked at one month post-discharge (48.3%) and subsequently decreased. Both prescribing-related DRPs (OR = 14.5, p = 0.012) and non-adherence-related DRPs (OR = 13.1, p < 0.001) were significantly associated with adverse clinical outcomes. Conclusion: DRPs related to prescribing and adherence are common in ACS patients and linked to adverse outcomes, underscoring the need for post-discharge medication review and adherence interventions to improve outcomes.

Author Biography

Thang Nguyen, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

Professor of Clinical Pharmacy at Can Tho University of Medicine and Pharmacy.

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